Provider Demographics
NPI:1649940834
Name:CAGGIANO, JOSEPH RYAN (MS, MSW,LCSW)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:RYAN
Last Name:CAGGIANO
Suffix:
Gender:M
Credentials:MS, MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 WINDEMERE AVE
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-5536
Mailing Address - Country:US
Mailing Address - Phone:352-409-7328
Mailing Address - Fax:
Practice Address - Street 1:819 W MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-3131
Practice Address - Country:US
Practice Address - Phone:321-800-8439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-17
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW226121041C0700X
FL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty